Are hospital management practices associated with enhanced quality of care for small and sick newborns? A nationwide cross-sectional study using linked inpatient admission records in Malawi

This study presents novel, national evidence on the association between hospital management practices and neonatal mortality in a low-income country, with complementary data on quality of clinical care. We found no evidence that hospital management practices were associated with neonatal mortality and limited evidence of an association with the quality of clinical care. Rigorous impact evaluations of targeted management interventions, with embedded process evaluations, could address potential confounders and help understand how and under what circumstances management improvements could translate into better quality of care.